A physician is using a pressure support protocol to wean a ...

[jayhills49]

A physician is using a pressure support protocol to wean a patient off ventilatory support. The patient is now at a 5 cm H2O pressure level and has a spontaneous respiratory rate of 21/min.
 
  Other cardiovascular and respiratory signs indicate that the patient remains stable. Which of the following actions would you recommend at this point?
  a. Switch the patient to 5 cm H2O continu-ous positive airway pressure (CPAP) through the endotracheal tube.
  b. Extubate the patient and provide supple-mental O2.
  c. Switch the patient to intermittent manda-tory ventilation at a rate of 2/min.
  d. Decrease the pressure support level to 3 cm H2O.

Question 2

An alert patient receiving ventilatory support through a demand flow intermittent mandatory ventilation system exhibits clinical signs of an increased work of breathing whenever you try to decrease the mandatory rate below 6/min.
 
  In order to aid in weaning this patient, which of the following would you recommend?
  a. Apply a low level of pressure support.
  b. Apply a high level of inspiratory pressure.
  c. Increase the mandatory VT.
  d. Decrease the mandatory VT.

[scikid]

Answer to Question 1

ANS: B
In general, patients who can spontaneously breathe comfortably at this level of pressure support can be extubated without problems.

Answer to Question 2

ANS: A
With intermittent mandatory ventilation, the addition of pressure support can overcome the work of breathing imposed during spontaneous breaths because of the presence of endotracheal and tracheostomy tubes, demand-flow systems, and ventilator circuits.

[jayhills49]

Thanks for the timely response, appreciate it

[diana chang]

Gracias!